Correlation Of Intestinal Microecology To Muscle Mass Loss In Patients With Liver Cirrhosis

Objective:Through metagenomic sequencing,the characteristics of the intestinal flora of the cirrhosis group and the healthy control group were clarified;To explore the relative abundance and meaningful flora of the cirrhosis patients with muscle mass loss group and normal muscle mass group at different levels,and provide clues and theoretical basis for further improving the malnutrition of patients with liver cirrhosis.Methods:We conducted a study on 60 patients with liver cirrhosis who were hospitalized in Shanxi Bethune Hospital from April 2019 to October 2019 and 30 healthy patients during the same period.We collected general information,biochemical,coagulation function and other indicators of patients with liver cirrhosis,according to the third lumbar skeletal muscle index(L3 SMI),the patients with liver cirrhosis were divided into a muscle mass loss group with 24 cases and a normal muscle mass group with 36 cases,and comparison of the muscle mass loss group and the normal muscle mass group in which indicators were statistically significant.At the same time,the feces of all selected subjects were taken,DNA extraction,metagenomic sequencing,and changes in the intestinal flora were analyzed.Results:1.This study showed that the BMI of healthy people was(24.8±4.1)kg/m~2,which was significantly greater than that of the cirrhosis group[(23.7±3.6)kg/m~2,P<0.05].2.The L3 SMI of the liver cirrhosis with muscle mass loss group was(30.9±5.1)cm~2/m~2,which was significantly lower than that of the normal muscle mass group[(52.0±12.9)cm~2/m~2,P<0.05];There were no significant differences in age,gender,cause,serological indicators,ascites,and MELD scores(P>0.05).3.The Shannon index of liver cirrhosis is(2.3±0.8),which is lower than that of healthy persons[(2.7±0.5),P=0.086];the Shannon index of the cirrhosis with muscle mass loss group is(2.1±0.8),significantly lower than the normal muscle mass group[(2.7±0.8),P<0.05].4.At the phylum level,Firmicutes and Bacteroidetes in the fecal flora of patients with liver cirrhosis are still the absolute dominant bacteria in the intestinal flora,followed by Actinobacteriap and Proteobacteria.5.At the phylum level,the relative abundance of Proteobacteria in the cirrhosis group was(6.2±7.9)%,which was significantly higher than that of healthy persons[(1.7±1.5)%,P<0.05];The relative abundance of Proteobacteria in the muscle mass loss group was(7.7±9.3)%,which was significantly higher than that in the normal muscle mass group[(3.6±4.1)%,P<0.05];6.At the species level,there are 16 bacterial species differences between the muscle mass loss group and the normal muscle mass group(P<0.05),Further correlation analysis found that the relative abundance of Lachnospiraceae bacterium and Bacteroides uniforms was significantly positively correlated with SMI(P<0.05).Conclusion:1.Compared with the healthy control group and the normal muscle mass group,the intestinal flora diversity of the liver cirrhosis group and the muscle mass loss group was reduced;2.At the phylum level,the relative abundance of Proteobacteria in the cirrhosis group and the muscle mass loss group was higher than that of the healthy control group and the normal muscle mass group;3.At the species level,there are 16 bacterial species differences between the muscle mass loss group and the normal muscle mass group;4.The relative abundance of Lachnospiraceae bacterium and Bacteroides uniforms in patients with liver cirrhosis was significantly positively correlated with SMI.